Personalized medicine, based on increasingly detailed and useful information about a patient's health and disease status, is allowing health care providers to better tailor treatment to individual patients for better outcomes. So far, we have only glimpsed the possibilities. In the future, it is possible that genetically driven precision medicine will guide not just treatment but also how we prevent disease and preserve health.

We don't yet know how far this infant science will develop. Further progress depends on the support of patients and on the protection of sensitive patient data.

Each day, at UC San Francisco, clinicians use blood tests or tissue biopsies to diagnose illness or monitor patients' health. Used this way, these samples help each individual patient. But, in addition, the "remnant" samples - blood or tissue that remains after all clinical tests have been completed - have the potential to help large numbers of people when they are used in medical research.

California law and federal regulations determine how researchers may use remnant samples in research. The central aim of these laws is to protect the privacy of patients and research volunteers. Laws seek to ensure that patients and research volunteers understand what might happen to them during a research procedure and what privacy protections they have. All hospitals, medical centers and research institutions must comply with these regulations.

The cornerstone of these regulations is the concept of informed consent. That is a process - and, usually, a document - that should explain to patients the intent of the research, how their tissue will be used, who will have access to their data, and how their privacy will be protected.

Obtaining consent for research sounds straightforward, but it can be challenging - especially when science is changing rapidly. Studies show that research consent is most meaningful when patients or research volunteers understand how donated tissue may be used. But, in a rapidly changing scientific environment, it is difficult to predict how scientists will use tissue samples even a few years from now. It is also difficult to predict how patients and research volunteers want their tissues used or what information they feel is most important to protect.

UCSF, along with other health care organizations and state and federal lawmakers, recognizes that the current systems for obtaining consent have fallen behind the pace of scientific advancement. New regulations have been proposed at the federal level, and state legislators are working on the problem. We recognize that this is a matter of great public concern.

At UCSF and across the UC system, we are working to improve all of our consent processes, especially consent for tissue donation. Through a project called EngageUC, we and our UC colleagues are leading efforts to create a comprehensive program to engage California's stakeholders and improve consent.

We want to develop a consent process and a set of policies that will help ensure that all patients - whether they have volunteered for specific research, are donating leftover tumor samples, or are being admitted to the hospital for care - truly understand what information may be gleaned from their samples, how that information will be used, whom it will be shared with, and what privacy controls can - and cannot - be guaranteed.

Our EngageUC project brings together researchers, policymakers, institutional officials and, most importantly, community members of the Bay Area and California to engage in an open, active, long-term discussion of this critical issue of consent. At UCSF and across the UC system, we are tackling this issue straight on and in partnership with the citizens of our state.

Elizabeth A. Boyd is an associate vice chancellor for ethics and compliance, and Daniel Dohan is an associate professor of health policy and social medicine at UCSF. They are co-directors of EngageUC.